The informed consent process should begin before you start cancer treatment. If you are getting more than one treatment, you will probably need to sign separate informed consent forms. For example, if you are having surgery to remove cancer and then will have chemotherapy or radiation to treat it, you will need to give consent for both surgery and either the chemotherapy or radiation.
Some medical procedures that may require you to give written informed consent include:
Parts of informed consent are regulated by state and case law. In general, those who make medical decisions must be recognized as adults in the state where the treatment is to be given. For children or others who are unable to make the decision for themselves, a parent or legal guardian is legally responsible for getting the information, making the decision, and signing the consent form. Some facilities require mentally competent older children who are being treated to give assent (willingness to participate) before they go into a research study, even after the parents have agreed on the child’s behalf. Assent means that, even though the parents sign the form, the child must also be okay with the plan before the facility will do the treatment.
There are times when the usual informed consent rules do not apply. This varies from state to state and may include:
A patient may wish to delegate his/her right to make informed decisions to another person. (See Advance Directives for more detailed information on this process.) This choice should be made to the extent permitted by the law. Sometimes, the patient may be unconscious or unable to make an informed decision. In these cases, the hospital must check their records for the patient's advance directives , medical power of attorney or the patient's representative. As soon as the patient is able to be informed of his/her rights, the health care provider must give the patient that information.
Another option is a court-appointed surrogate or proxy. This is someone a judge chooses to make decisions for you if you become unable to make decisions for yourself. Some states have passed family agency acts that choose which family members (listed in order of priority) may act on behalf of a patient if the patient doesn't have an advance directive or medical power of attorney.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Centers for Medicare & Medicaid Services (CMS). Revisions to the hospital interpretive guidelines for informed consent. 2007. Accessed at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/downloads/SCLetter07-17.pdf on February 19, 2019.
Katz AL, Webb SA, Committee on Bioethics. Informed consent in decision-making in pediatric practice. AAP News & Journals; 2016;138(2):e1-e13.
MedlinePlus. Informed consent-adults. 2017.Accessed at https://medlineplus.gov/ency/patientinstructions/000445.htm on February 19, 2019.
Moye J, Sabatino CP, Brendel RW. Evaluation of the capacity to appoint a health care proxy. American Journal of Geriatric Psychiatry; 2013;21(4):326-336.
Storm C, Casillas J, Grunwald H, Howard DS, McNiff K, Neuss MM. Informed consent for chemotherapy: ASCO member resources. Journal of Oncology Practice; 2016;6:289-295.
Last Revised: May 10, 2019